Risk of new aneurysms after surgery for popliteal artery aneurysm.

BACKGROUND

The risk of developing a new aneurysm after surgery for popliteal artery aneruysm (PAA) is not well known. The aim was to study this risk in a cohort of patients.

METHODS

A total of 571 patients who had primary operation for PAA (717 legs) between 1987 and 2002 were identified from the Swedish Vascular Registry (Swedvasc). Of these, 190 patients were re-examined by ultrasonography after a median of 7 (range 2.9-18.7) years.

RESULTS

The number of patients with at least one aneurysm in addition to the PAA was 108 (56.8 per cent) at the index operation and 131 (68.0 per cent) at re-examination. The overall number of aneurysms increased by 41.8 per cent, from 244 to 346. Among the 82 patients who had an isolated PAA at the index operation, 23 developed a new aneurysm; these patients tended to be older (P = 0.004). Bilateral PAA at the index operation was associated with a later development of abdominal aortic aneurysm (P = 0.004). Age (P = 0.004) and hypertension (P = 0.012) at the time of the index operation were associated with multianeurysm disease at any time. Six (4.3 per cent) of 138 legs treated by venous bypass grafts had developed a graft aneurysm by the time of re-examination. No normal arterial segment developed an aneurysm that required surgery within 3 years.

CONCLUSION

The development of new aneurysms was common in patients with a PAA; lifelong surveillance may be warranted.